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Review
. 2015 Jun;47(2):90-4.

The History of Goal-Directed Therapy and Relevance to Cardiopulmonary Bypass

Laurie Dijoy, John Scott Dean, Carla Bistrick, Joseph J Sistino
Review

The History of Goal-Directed Therapy and Relevance to Cardiopulmonary Bypass

Laurie Dijoy et al. J Extra Corpor Technol. 2015 Jun.

Abstract

Goal-directed therapy is a patient care strategy that has been implemented to improve patient outcomes. The strategy includes aggressive patient management and monitoring during a period of critical care. Goal-directed therapy has been adapted to perfusion and has been designated goal-directed perfusion (GDP). Since this is a new concept in perfusion, the purpose of this study is to review goal-directed therapy research in other areas of critical care management and compare that process to improving patient outcomes following cardiopulmonary bypass. Various areas of goaldirected therapy literature were reviewed, including fluid administration, neurologic injury, tissue perfusion, oxygenation, and inflammatory response. Data from these studies was compiled to document improvements in patient outcomes. Goal-directed therapy has been demonstrated to improve patient outcomes when performed within the optimal time frame resulting in decreased complications, reduction in hospital stay, and a decrease in morbidity. Based on the successes in other critical care areas, GDP during cardiopulmonary bypass would be expected to improve outcomes following cardiac surgery.

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Conflict of interest statement

The senior author has stated that the authors have reported no material, financial, or other relationship with any healthcare-related business or other entity whose products or services are discussed in this paper.

Figures

Figure 1.
Figure 1.
Conceptual model for reviewing goal-directed therapy (GDT).
Figure 2.
Figure 2.
Flow chart for selection of research papers related to goal-directed therapy (GDT).
See this image and copyright information in PMC

References

    1. Fergerson BD, Manecke GR Jr.. Goal-directed therapy in cardiac surgery: Are we there yet? J Cardiothorac Vasc Anesth. 2013;27:1075–1078. - PubMed
    1. De Backer D, Aldecoa C, Njimi H, Vincent JL.. Dopamine versus norepinephrine in the treatment of septic shock: A meta-analysis. Crit Care Med. 2012;40:725–730. - PubMed
    1. Ekbal NJ, Dyson A, Black C, Singer M.. Monitoring tissue perfusion, oxygenation, and metabolism in critically ill patients. Chest. 2013;143: 1799–1808. - PubMed
    1. Baker RA, Bronson SL, Dickinson TA, et al. . Report from AmSECT’s International Consortium for Evidence-Based Perfusion: American Society of Extracorporeal Technology Standards and Guidelines for Perfusion Practice: 2013. J Extra Corpor Technol. 2013;45:156–166. - PMC - PubMed
    1. de Somer F, Mulholland JW, Bryan MR, Aloisio T, Van Nooten GJ, Ranucci M.. O2 delivery and CO2 production during cardiopulmonary bypass as determinants of acute kidney injury: Time for a goaldirected perfusion management? Crit Care. 2011;15:R192. - PMC - PubMed

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